MEDICARE: PARKVIEW WABASH HOSPITAL, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1922515907
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARKVIEW WABASH HOSPITAL, INC.

Provider Business Mailing Address
First Line	:	1104 N WAYNE ST
Second Line	:
City	:	NORTH MANCHESTER
State	:	IN
Zip	:	46962-1001
Country	:	US
Telephone Number	:	260-982-2102
Fax Number	:

Provider Business Practice Location Address
First Line	:	1104 N WAYNE ST
Second Line	:
City	:	NORTH MANCHESTER
State	:	IN
Zip	:	46962-1001
Country	:	US
Telephone Number	:	260-982-2102
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	MRS. JESSICA LEE-HANSEN
Credential	:
Telephone Number	:	312-388-0125

Provider Enumeration Date	:	12/29/2017
Last Update Date	:	03/02/2026

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